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Understanding and Managing Peripheral Facial Nerve Palsy (Bell's Palsy) with Acupuncture



Peripheral facial nerve palsy, commonly known as Bell's palsy, is often induced by facial neuritis. It can also arise from facial nerve trauma. Immediate acupuncture treatment at the onset of this condition yields excellent results and should be the preferred method of treatment. Acupuncture also shows efficacy during the sequelae phase of the condition.


Since Bell's palsy affects facial appearance, patients usually seek prompt and complete recovery. Factors influencing prognosis include the severity of the condition and the timeliness and effectiveness of treatment. Older patients over 60 years, those with recurrent episodes, or those with vascular causes generally have poorer outcomes. In conventional medicine, facial nerve excitability tests conducted within two weeks of onset can predict prognosis. Mild cases without degenerative response often recover fully within 1-2 months. Partial degeneration may take 3-6 months to recover, while cases with complete degeneration after two months may recover slowly (over a year) or not at all. However, the early disappearance of electric stimulation response does not necessarily indicate non-recovery. In cases where recovery has not occurred after six months, the chances of complete recovery are slim, with about 80% of cases recovering within 2-3 months.


To improve recovery rates, it is best to begin comprehensive treatment early to minimize degeneration of facial nerves and muscles. This includes immediate acupuncture, local heat application, and infrared irradiation. Some cases are triggered post-cold, possibly related to viral infections, warranting concurrent antiviral Chinese medicine treatment. Many patients are physically weakened during the acute phase, thus rest and good sleep are vital, along with increased protein intake, reducing eye strain from activities like TV, phone, or computer use, and daily massage and heat application to the affected ear and facial area.


Acupuncture's immediate effect on facial nerve muscle excitability and its efficacy in post-Bell's palsy recovery are undeniable. Acupuncture mechanisms include improving local blood circulation and reducing edema and inflammation in the acute phase, preventing further damage to the facial nerve, and promoting nerve function recovery during the rehabilitation phase. Reports indicate that severe facial palsy patients show chronic ischemia in paralyzed facial tissues, which can normalize post-acupuncture. Effective acupuncture treatment often results in reduced pathological potentials or increased normal motor unit potentials in electromyography (EMG) tests of affected muscles.


Clinical reports and experience suggest that acupuncture can indeed accelerate recovery and improve cure rates in Bell's palsy, with varying outcomes depending on the treatment method. The efficacy of acupuncture is significantly related to the timing of its initiation. Starting treatment within a week or 10 days of onset can minimize nerve damage and aid in full recovery. The extent of nerve degeneration directly influences the response to acupuncture and thus the treatment outcome. Patients with partial nerve degeneration respond better than those with complete degeneration. Delayed treatment of over a month results in slower recovery. However, persistent acupuncture treatment for post-Bell's palsy sequelae can still yield varying degrees of recovery, so treatment should not be easily abandoned.

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